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NPI Code Detail

MEDICARE: MARCELO ERNESTO BRITO TELLES MD

MEDICARE: MARCELO ERNESTO BRITO TELLES MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine PhysicianQ1103TX
2207QA0505XAdult Medicine PhysicianQ1103TX

General Provider Information

NPI Number : 1699062018
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARCELO ERNESTO BRITO TELLES MD
Provider Business Mailing Address
First Line : 2812 DORSET
Second Line :
City : THE COLONY
State : TX
Zip : 75056-3592
Country : US
Telephone Number : 779-770-7011
Fax Number :
Provider Business Practice Location Address
First Line : 1512 TEASLEY LN
Second Line :
City : DENTON
State : TX
Zip : 76205-7282
Country : US
Telephone Number : 940-566-5010
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/06/2011
Last Update Date : 12/22/2021

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Directions to “ MARCELO ERNESTO BRITO TELLES MD” Practice Location

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